Summary Of Breast Reconstructions Options

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Breast Implant/ Expander 

Advantages

• Breast Implant / Expander

• Short Operation

• Good results are possible in selected cases

 

​Disadvantages

• Limited size of breast due to lack of skin

• Scar capsule problems

• Implant infection

• Implant exposure

• May require Alloderm for implant coverage

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Breast Implant with Latissimus Dorsi Myocutaneous Flap 

​Advantages ​

• Intermediate length procedure

• Good results are possible

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Disadvantages

• Implant infection

• Scar capsule

• Large back scar

• Loss of muscle function

• May require Alloderm for implant coverage

 

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Latissimus Dorsi Myocutaneous Flap

 

​Advantages 

• Autogenous Tissue

• Soft natural breast

• Reliable blood supply

• Fair to good size

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Disadvantages

• Often limited breast size

• Large back scar

• Loss of muscle function

 

TRAM Myocutaneous Flap

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 Advantages

• Autogenous Tissue

• Soft natural breast

• Reliable blood supply

• Large breast mound

• Abdominoplasty Closure

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 Disadvantages 

• Includes some muscle and fascia

• Abdominal weakness

• Occasional need for mesh to support abdominal fascia repair

 

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Free TRAM, Transverse Rectus Abdominis Flap

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 Advantages

• Autogenous Tissue

• Soft natural breast

• Excellent blood supply

• Large breast mound

 

Disadvantages 

• More complex procedure

• Removes a little muscle and fascia

• Abdominal weakness and hernia are less than with pedicle TRAM flaps

 

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DIEP, Deep Inferior Epigastric Perforator, Flap

​Advantages

• Autogenous Tissue

• Soft natural breast

• Good to excellent blood supply

• Large breast mound

• Minimal violation of fascia and muscle

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Disadvantages 

• More complex dissection than free TRAM

• Cuts rectus abdominis fascia, and dissects through muscle

• Potential abdominal hernia or weakness

 

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SIEP, Superficial Inferior Epigastric Perforator Flap

​Advantages

• Autogenous Tissue

• Soft natural breast

• Good to excellent blood supply

• Large breast mound

• No violation of fascia or muscle

• Abdominoplasty closure

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Disadvantages 

• Complex dissection

• Variable vascular pattern

 

S-GAP, Superior Gluteal Artery Perforator

Advantages

• Autogenous Tissue

• Soft natural breast

• Good blood supply

• Large breast mound

• Well hidden scar

 

Disadvantages

• Complex dissection

• Requires patient position changes during surgery

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I-GAP, Inferior Gluteal Artery Perforator Flaps

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Advantages

• Autogenous Tissue

• Soft natural breast

• Good blood supply

• Large breast mound

• Well hidden scar

 

Disadvantages

• Complex dissection

• Requires patient position changes during surgery

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